1. TED—Time and life saving External Defibrillator for home-use☆
Teddy A. Weiss ⁎, Shimon Rosenheck, Shraga Gorni, Ioni Katz, Mendel Mendelbaum, Dan Gilon
Cardiology Dept., Hadassah University Hospital, Jerusalem, Israel
a b s t r a c ta r t i c l e i n f o
Article history:
Received 12 March 2014
Accepted 13 March 2014
Keywords:
Defibrillator
AED
Home
Low-cost
Home consumer
Sudden Cardiac Death — SCD — is a major unmet health problem that needs urgent and prompt solution.
AICDs are very expensive, risky and indicated for a small group of patients, at the highest risk. AEDs — Automatic
External Defibrillators — are designed for public places and although safe, cannot enter the home-market due to
their cost and need for constant, high-cost maintenance. We developed TED, a low-cost AED that derives its
energy off the mains, designed for home-use, to save SCD victims' lives.
© 2014 Elsevier Inc. All rights reserved.
Sudden cardiac death (SCD) – caused by ventricular fibrillation
(VF) or standstill – occurs in about 350,000 persons every year in the
US alone and in about 3 million worldwide and the majority of them
occur in the low-risk group at relatively younger age, in their best
years of life, usually witnessed — at home or office. Since survival
drops by 10% for every minute delay, no ambulance in the world will
be quick enough to save them or leave them without neurological
damage that will put them in a nursing home, at a huge cost for family
or society. Since SCD may occur in apparently healthy people, without
any preceding symptoms, all people, especially above age 40 or at risk
for myocardial infarction, are at risk.
Therefore every home or office should have a defibrillator device,
exactly like they have fire-extinguishers, but isn't our life more
precious than our home? Of course the first group in urgent need for
such a device is the high risk group for sudden death: those with
reduced heart function after heart attacks; part of them will get
automatic implantable defibrillators (AICDs) at a cost of approxi-
mately $20,000 each, but those uninsured or not eligible due to co
morbidities or high age or during the first month after acute MI or
CABG and the big rest of the world (developing countries)-no
economy there can afford AICD implantation to all who need it-and
it will be recommended by physicians to have at least a low-cost
automatic external defibrillator(AED). AICDs require surgical implan-
tation and may deliver inappropriate shocks and thus are risky. These
devices can also cause grave psychological effects, especially to the
young and elderly, with end-of-life dilemmas. Patients with AICDs
need constant care, follow-up in dedicated centers and replacement.
The existing AEDs, which are now distributed in public places such
as in airports, airplanes and schools and are purchased more and
more – although approved by FDA for home use several years ago –
are not a good solution for home-use, due to their high cost (about
$1000–$2000 each) for battery and capacitor not needed in TED and
their big maintenance problem; such a device that lies for years in the
office or home and not in use may not work in the instance you
urgently need it due to battery or capacitor failure. They do not have
pacing capabilities due to their limited energy source and only 7% of
SCD victims were relatively close (within 4 min distance to an AED).
Our TED device, modifies by computer the sinusoidal alternating
electrical current from the mains to a biphasic defibrillatory wave, similar
to that of standard AED (see Figure). Since it derives its energy from the
mains, it will always be operational as long as it will be plugged in via a
running cord to the mains outlet and its cost is affordable to every
household — about 300$ only and even less if mass production (as
expected) will be used. In addition since there is no need to charge the
capacitor it may deliver immediately repeated shocks in case of failed
shocks, at a higher energy and to externally pace the heart in case
bradycardia or standstill caused SCD or it occurred after the electric
shock. It may also use rapid pacing to stop ventricular tachycardia instead
of shock—all these features cannot be delivered by existing AEDs. Our
device will drastically reduce the huge number of sudden cardiac deaths
as well as may be reimbursed by insurance companies or HMOs since this
will solve a huge unmet need with an unlimited market.
In order to prove the safety and feasibility of TED, we performed 2
animal experiments; in the first, we used 5 small pigs (30–40 kg body
weight) that were anesthetized with ketamine and isoflurane. A
single quadripolar pacing catheter was inserted percutaneously
through one of the femoral veins or jugular vein. VF was induced
with rapid ventricular burst pacing or T wave shock and defibrillation
of stable VF after 15 s was applied by TED or by a standard AED.
Defibrillation thresholds were compared using a step-down protocol
and found to be similar. The second experiment used a rat model: six
rats, with a mean weight of 492 g, underwent a mid LAD coronary
Cardiovascular Revascularization Medicine 15 (2014) 233–234
☆ This is an invited submission based on our CRT 2014 Cardiovascular Innovation.
⁎ Corresponding author. Tel.: +972 504 770 744.
E-mail address: atweiss@hadassah.org.il (T.A. Weiss).
http://dx.doi.org/10.1016/j.carrev.2014.03.006
1553-8389/© 2014 Elsevier Inc. All rights reserved.
Contents lists available at ScienceDirect
Cardiovascular Revascularization Medicine

2. surgical closure at 3 months age and 3 months later VF was induced
and TED defibrillation was successfully achieved in all, repeatedly.
External pacing was successfully achieved using TED in all, at a heart
rate above their sinus rate, for an unlimited time before and after
defibrillation. We conclude that modified alternating shock delivered
by our device – TED – is feasible and as effective as that of the standard
biphasic direct current defibrillator. Repeated higher energy shocks
are quickly available; external pacing is feasible and durable due to
unlimited energy. We suggest this type of defibrillation shock to be
implemented in Automatic External Home Defibrillators. This low-
cost new technology should be used to treat sudden cardiac arrest
occurring at home/office.
Figure. A biphasic waveform (in red) derived from the sinusoidal alternating current (in blue) off the mains.
234 T.A. Weiss et al. / Cardiovascular Revascularization Medicine 15 (2014) 233–234